After witnessing a 36-hour labor that ended with the use of forceps for delivery, Zavo Gabriel worried that his wife Annie Ranttila was in distress.
“It was really difficult for me seeing the look on her face when she was pushing the hardest. She was screaming and making these noises, which sounded like someone pushing for her life,” Gabriel, 36, a product manager at a robotics company in Pittsburgh, told TODAY Parents. “It was a very visceral experience.”
Gabriel thought he was prepared for fatherhood. He read all the books and took all the classes, and he and Ranttila had a great relationship with their doula. But nothing prepared him for the overwhelming emotions he started experiencing after the birth of their son, Arthur. He remembers one night when Arthur had hiccups, which Gabriel normally thinks sounds adorable. Yet, every hiccup sent a jolt of panic through his body.
“I was lying there sort of with my back to the rest of the room aggressively closing my eyes. The panic attack was bad,” he recalled. “I was having multiple panic attacks a day.”
“The estimate is higher than depression in the normal population,” said Sheehan D. Fisher, an assistant professor in the psychiatry and behavior sciences department at Northwestern University's Feinberg School of Medicine. “A father’s depression has a direct link to the child. It definitely impacts the whole family’s health.”
How men experience postpartum depression
While experts once thought that the changing hormones associated with pregnancy and childbirth caused postpartum depression in women, they now understand that multiple factors can cause it. Women who have a history of mental illness, increased stress in their lives, or dramatic hormonal changes during periods are more likely to suffer postpartum mental illness. Some of these same causes impact men.
“Postpartum depression is caused by a number of physical and social causes: being overly stressed or sleep-deprived, having a history of depression,” said Brandon Eddy, an assistant professor in the Couple & Family Therapy Program at the University of Nevada, Las Vegas. “It is occurring in men for much the same reason.”
Early research studies also have shown a surprising biological link for some new dads as well. Much like new mothers, some new fathers also experience hormone changes; their testosterone levels can dip when they become dads. In studies of older men, there’s a relationship between lower testosterone levels and mental health.
“In older men, when testosterone drops, it is linked to depression,” Fisher explained. “Fathers actually have their testosterone decrease over time.”
That’s not to say that postpartum depression and anxiety are the same in fathers as mothers.
“The woman is giving birth and she goes through pregnancy and the hormones,” said Dr. Samantha Meltzer-Brody, director of the perinatal psychiatry program at UNC School of Medicine's Center for Women’s Mood Disorders. “It is qualitatively different.”
But just because it is different doesn’t mean it is any less serious.
“It is almost like saying, ‘What’s worse: if the mother or the father gets cancer in the first year of a child's life?’” Meltzer-Brody said.
Recognizing postpartum mental illness in men
While both men and women experience similar symptoms when it comes to depression — such as sadness or lack of interest — men’s depression looks different.
“Men are more likely to externalize with aggression, drinking, drug use,” Fisher said.
They’re also more likely to be absent, leaving moms without support.
“We know that how the mother is doing is often influenced by the father,” Meltzer-Brody said. “We need to be figuring out how we care for dads and really helping with policies that support families.”
Fathers are less likely to be screened for postpartum mental illnesses or to seek treatment, experts say. Often, if men do speak up, they become the butt of jokes or are dismissed.
“It shouldn’t be belittled,” Fisher said. “We need to change the culture of what masculinity is and be more inclusive about why fathers’ experiences matter.”
In Gabriel's case, he sought out distance in a way that experts say is common. When Gabriel’s anxiety and depression were at their worst, he couldn’t handle staying with his family, though he visited daily.
“I was a total wreck,” he said. “Annie’s mom had to step in and be the co-parent for those first few weeks.”
A friend and his doctor both realized that Gabriel was experiencing postpartum depression and anxiety and encouraged him to get help. He completed six weeks of outpatient therapy and found a therapist for ongoing treatment. Today he feels much better and enjoys the bond that he shares with 10-month-old Arthur.
“That was probably the most stressful time,” he said. “All I wanted was to get back to Annie and starting this life as a family.”